The effect of the distance from the pyloric sphincter and size of the calibration tube on ­postoperative outcomes of the laparoscopic sleeve gastrectomy

Aim. To study of the effect of the diameter of the calibration tube and the distance from the pyloric sphincter on the outcomes of the laparoscopic sleeve gastrectomy.

Methods. The study included 945 (915 women) patients with a body mass index 51.5±9 kg/m2. The average age of the patients was 53.5±8.5 years. The patients were divided into 2 groups by the type of laparoscopic surgery: in the first group (n=463), a 36 Fr calibration tube was used, the distance from the pyloric sphincter was 4–6 cm; in the second group (n=482), a 32 Fr calibration tube was used, the distance from the pyloric sphincter was 2–3 cm. The main comparison criteria was the percentage of body weight loss in the first 6 and 12 months, and an additional comparison criteria was the of concomitant diseases progress in postoperative and the existence of complications.

Results. A comparative analysis showed that the first group in the first 6 months lost 59±3% of its initial body weight, while in 12 months — 71±4%; in the second group, 73±3 and 87±3% of the initial weight, respectively. Concomitant diseases in the first group decreased by 70–80% by the 6th month after surgery and by 85–96% by the 12th month. In the 2nd group, similar remission with improvement was between 84 and 94% at the 6th month, and remained the same at the 12th month.

Conclusion. The results of the study show that in laparoscopic sleeve gastrectomy with a calibration tube diameter 32 Fr and a distance of 2–3 cm from the pyloric sphincter, compared to a calibration tube diameter 36 Fr or more and a distance of 4–6 cm from the pyloric sphincter, a body weight loss faster and more effective with earlier remission of concomitant diseases, while the number of complications is comparable.